Nasopharyngeal cancer in Nigeria

Nasopharyngeal cancer, once considered to be non-existent or rare in the African, is now accepted as being far from uncommon. Experience of this disease in Nigeria over a 15-year period is presented. As elsewhere there is a preponderance of males over females, but the peak age of incidence is lower than that observed in the Western world. Cancers of epithelial origin predominate. The commonest early sign of the disease is upper deep cervical adenopathy usually, but not always, with nasal and/or aural symptoms. Cranial nerve involvement has been observed early in about 30% of cases and occasionally this may be the only symptom or sign at first presentation and so may require a high index of suspicion to discover its origin. Viral, environmental and other possible etiological factors are considered. Delay in seeking or being referred for hospital treatment is common, and patients often present at such an advanced stage that only palliation can be offered. The cure and survival rates, not surprisingly, are low. Increasing awareness of the prevalence of the disease at all ages and alertness in recognizing its various presenting features are essential, as are early diagnosis and improved facilities for treatment. Elimination of suspected environmental and other controllable etiologies, and efforts to provide immunization against the viruses concerned are needed to help in reducing the incidence of the disease.